Appendix 10 - PAST PERFORMANCE INFORMATION FORM.doc

DOC document 122 KB Posted Jul 3, 2008

Attached to: Electronic Media Services
Solicitation number: BPD-TTB-08-CI-0003
Issued by: Department of the Treasury Bureau of the Fiscal Service

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Appendix 10

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Appendix 10 memorandum

Department of the Treasury, Bureau of the Public Debt

Division of Procurement

TO:

PROSPECTIVE EVALUATORS

FROM:

Jane Oney, Contracting Officer

DATE:

July 3, 2008

SUBJECT:

Solicitation BPD-TTB-08-CI-0003 Past Performance Questionnaire

Electronic Media Services

The Bureau of the Public Debt is conducting a proposal evaluation for subject solicitation. The point of contact listed in the attached questionnaire has identified your office as a source to evaluate the contractor’s past performance and it also authorizes release of this information to our office.

The individual most knowledgeable of the contractor’s day-to-day operations and overall condition of performance rendered should complete the survey. However, that individual is encouraged to supplement their own knowledge with the judgment of others in their organization, if appropriate.

Please complete the questionnaire as thoroughly as possible by indicating your ratings and providing comments wherever applicable. For any rating of P or U, request you provide an explanatory narrative and attach to your response. The narratives need not be lengthy, but should be detailed and descriptive. Use separate evaluation forms for each contract/order being evaluated.

Your time and effort in providing this information is greatly appreciated. The requested information is critical to our evaluation. Please complete and return the completed package as quickly as possible but not later than 2:00 PM ET on July 30, 2008. You may e-mail a scanned copy to psb3@bpd.treas.gov Attn: Michelle Clegg – BPD-TTB-08-R-0003, Fax it to 304-480-7204, or mail it to the following address:

Bureau of the Public Debt

Division of Procurement

Attn: Michelle Clegg – BPD-TTB-08-R-0003

200 Third Street, Avery 5F

Parkersburg, WV 26101

If you have any questions, please call Michelle Clegg at 304-480-7129. Thank you for your cooperation and quick response to this request.

PAST PERFORMANCE INFORMATION FORM

Solicitation:

BPD-TTB-08-CI-0003

Type of Product:

Electronic Media Services

Contractor’s Name Being Evaluated:

Work was performed as a:

FORMCHECKBOX

Prime or

FORMCHECKBOX

Sub Contractor.

CONTRACT TITLE/DESCRIPTION:

TASK(S) PERFORMED:

FORMCHECKBOX

Web Based Training

FORMCHECKBOX

Regulated Industry CDs/DVDs

(Check all that apply.)

FORMCHECKBOX

Electronic Document Management

CONTRACT SPECIFICS:

1. Contract Number:

2. Contract Type:

3. Size of Contract:

# of Employees

Total Contract Value

4. Period of Performance:

Comments/Remarks:

POINT OF CONTACT (Individual completing form):

Company Name:

Name:

Title:

Office:

Email:

Telephone:

Quality of Product or Service

Rating Guideline

When responding to the descriptive statements, select the letter, which most accurately describes the contractor’s performance or situation.

Unsatisfactory

Non-conformances are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements.

Poor

Overall compliance requires significant Agency resources to ensure achievement of contract requirements.

Fair

Overall compliance requires minor Agency resources to ensure achievement of contract requirements.

Good

There are no, or very minimal, quality problems, and the Contractor has met the contract requirements.

Excellent

There are no quality issues, and the Contractor has substantially exceeded the contract performance requirements without commensurate additional costs to the Government.

Outstanding

The contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example for others, so that it justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent".

Not Applicable

The contractor was not required to perform or this was not covered under this contract.

QUALITY of PRODUCT OR SERVICE:

N/A

Contractor provided effective quality control and inspection procedures that resulted in a quality-finished project.

FORMCHECKBOX

Quality accurate of monthly status reports and required deliverables.

FORMCHECKBOX

Contractors ability to remain within acceptable quality levels.

FORMCHECKBOX

Contractors ability to anticipate and resolve problems.

FORMCHECKBOX

Contractors process in recovery of delays.

FORMCHECKBOX

Contractors reaction time and appropriateness of response to change.

FORMCHECKBOX

Assessment of the ability to meet the functional and performance requirements of tasks.

FORMCHECKBOX

II.

COST CONTROL:

N/A

The contractor submits proposals that accurately represent the work required.

FORMCHECKBOX

The contractor’s supporting price/cost information for modifications is accurate, complete and reasonable (not over inflated or under estimated).

FORMCHECKBOX

How would you rate the contractor’s overall Cost Control performance.

FORMCHECKBOX

Offer Innovative/Creative procedures to decrease cost.

FORMCHECKBOX

III.

TIMELINESS OF PERFORMANCE:

N/A

Contractor met timely completion of key milestones and tasks, as scheduled.

FORMCHECKBOX

Contractor performed all work without the issuance of a CURE NOTICE or a SHOW CAUSE LETTER.

FORMCHECKBOX

IV.

BUSINESS RELATIONS:

N/A

Assessment of Contractors ability to identify, analyze and prioritize risks.

FORMCHECKBOX

Contractor performed within the Occupational Health and Safety Administration (OSHA) standards.

FORMCHECKBOX

Contractors ability to manage and control security.

FORMCHECKBOX

Contractor provided experienced/qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

FORMCHECKBOX

Contractor hired, maintained, and replaced as necessary, qualified personnel.

FORMCHECKBOX

Contractor ensured the Project Manager had sufficient authority to make decisions and take actions during project performance to keep the project on schedule.

FORMCHECKBOX

Contractor paid employees as required.

FORMCHECKBOX

The contractor cooperated to resolve problems, attended meetings and maintained communication to assure satisfactory resolution.

FORMCHECKBOX

Offer Innovative/Creative procedures to streamline processes and improve operation performance.

FORMCHECKBOX

OVERALL PERFORMANCE:

N/A

Rate the overall performance of this contractor. Would you rehire this contractor?

FORMCHECKBOX

ADDITIONAL COMMENTS:

Return the complete package to the Contracting Office as indicated in the above memorandum.

File details come from the government source that posted it. Updated Nov 14, 2017.